A 31-Year-Old Man Comes to the Office for a Routine

question 50

Multiple Choice

A 31-year-old man comes to the office for a routine annual examination.  The patient mentions that he is engaged to be married, but adds that he is not sure he is ready to make a commitment.  He says, "I love my fiancée, but I have recently had some relationships with men.  My fiancée wants to have children as soon as we are married, but I feel 'boxed in' by this and want to be absolutely sure that this is what I want."  The patient feels conflicted, as he enjoys sex with his fiancée but wonders about other options.  He has had sexual intercourse with men in the past and has used condoms most of the time.  The patient does not use illicit drugs, except for MDMA occasionally at parties.  Examination shows oral thrush and generalized lymphadenopathy.  The rest of the physical examination is normal.  When the physician recommends that the patient undergo HIV testing, he refuses.
Which of the following would be the most appropriate response to this patient?

• A)I am concerned that your refusal of HIV testing places both you and your fiancée at risk.
• B)I respect your decision to refuse HIV testing, but we should discuss methods for safe sex.
• C)I understand your fears, but HIV is very treatable and testing is the first step.
• D)I would like to understand your reservations about being tested.
• E)It is your decision to decline HIV testing, but I must report this to the Department of Public Health.

Understand the biological and psychological factors influencing human hunger and eating behaviors.

Grasp the concepts and stages of the human sexual response cycle.

Comprehend the influence of hormones on sexual orientation and gender identity.

Understand the theories explaining human emotions and their physiological and cognitive components.

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Definitions:

Sexual Development

The process of physical and emotional changes that occur as a person matures sexually, including puberty and the development of sexual orientation.

Phallic

Referring to the third stage in Freud's psychosexual stages of development, focusing on the pleasure zone of the genitals.

Latent

Hidden or dormant, not currently visible, active, or symptomatic, but with the potential to emerge or become active.

Genital

Refers to the reproductive organs in both males and females, often discussed in the context of sexual development and function.